Individual
MRS. JENICE IVETTE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
1035 CHERAW STREET, BENNETTSVILLE, SC 29512
(843) 454-0841
(843) 454-0635
Mailing address
PO BOX 918, BENNETTSVILLE, SC 29512
(843) 454-0841
(843) 454-0635
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
—
—
Other
Enumeration date
06/08/2017
Last updated
10/15/2021
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